From the epidemiologists who track death rates to battle-weary emergency room doctors and nurses who patch up wounded children, there is a growing movement to push new legislative, educational and political strategies to end gun violence.
The newly appointed head of the U.S. Centers for Disease Control and Prevention recently targeted violence as one of the major public health issues of the decade. In the past few months, several different groups have declared that they will campaign to attack violence with some of the same strategies that successfully persuaded people to quit smoking and to buckle up.
The main goal is to get the guns out of homes and the hands of children. Among the strategies being considered are new taxes and laws to restrict access to guns or to ban certain types of guns and bullets.
Those strategies are likely to face tough opposition from the gun lobby, led the National Rifle Association, just as anti-smoking laws have been fought by the tobacco lobby.
“The goal is an ultimate ban on all guns, but we also have to take a step at a time and go for limited access first,” said Joyner Sims, deputy commissioner in charge of injury control for the Florida State Health Department.
“Lawmakers are scared to death of this issue. If we create anger and outrage on a national level, it would really help the local folks.”
Just as seat belts and air bags have saved lives without the need to improve anyone’s driving skills, researchers say that making guns less plentiful and accessible would immediately cut the death and injury rate without the need to wait for solutions to the underlying causes of violence.
“Anything we can do to get guns out of the hands of children and out of homes would reduce the fatality rate,” said Dr. David Satcher, who was named head of the CDC by President Clinton in August.
“They may still fight,” said Satcher, 52. “But they’ll do it like we did, with fists and maybe rocks. Not with guns.”
Of the 55 children under 15 who have been slain so far this year in the Chicago area, 28 were shot, four more than in all of 1992.
Nationally and locally, organizations and activists are taking up the cause to recast guns and violence as a public health issue.
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Among them:
– A nationwide group of more than 100 associations-universities, state health departments and the American Bar Association among them-called the HELP Network of Concerned Professionals held its inaugural meeting in Chicago this month. The group is organized around a single issue: “to reduce the handgun epidemic by addressing it as a public health problem,” according to its founder, Dr. Katherine Kaufer Christoffel of Children’s Memorial Hospital.
– Physicians for a Violence-Free Society was founded in January in San Francisco as a nonprofit organization dedicated to developing techniques that doctors and communities can use to prevent violence.
– The American Academy of Pediatrics has made the prevention of firearm injuries a priority. It has adopted a strong gun-control policy designed to keep guns out of the hands of children and to require that guns have trigger locks and an indicator that signals when the gun is loaded.
– At the University of Illinois College of Medicine, Dr. Virginia Bishop-Townsend, head of adolescent medicine teaches residents to ask patients about the presence of guns in their homes to try to prevent gun-related injuries.
– The Chicago Department of Health and the Cook County Bureau of Health Services have created the Chicago Area Anti-Violence Project to evaluate violence reduction projects and produce a video for young children on the dangers of handguns.
The activists hope to follow formulas that have been the most successful in reducing automobile fatalities over the past decades.
The increase in automotive safety, for example, has been primarily due to legal changes that require minimal driver cooperation: laws requiring seat belts, air bags, and child safety seats, and enforcing tougher drunken driving laws.
Activists are also taking lessons from the successes in the war against tobacco use.
Although information about the dangers of smoking helped reduce the percentage of adults who smoke to 26 percent in 1991 from 40 percent in 1965, it was the federal clean air laws that allowed non-smokers to avoid second-hand smoke and finally made it so inconvenient to smoke that many people quit.
“Education is good, but it takes a long time, and it is very slow to show an impact,” Sims, of the Florida Health Department, said. “We need legislation.”
Some legal experts believe that personal injury and product liability laws could be used to battle the gun industry.
For example, with sufficient research to determine the relative risks and benefits of owning guns, companies might some day be sued for false advertising if they marketed a gun for protection when research showed guns made homes more dangerous, some legal experts say.
A study reported this month by Dr. Arthur Kellerman of Emory University in Atlanta found that people with guns in their homes were three times as likely to be shot to death.
Other studies have shown teenagers in homes with guns were five times as likely to die in suicide attempts.
That kind of information could become the basis for a warning on advertisements for handguns similar to those now familar on cigarettes: “Caution: Having a gun in your house can greatly increase your risk of being shot or having your teenager commit suicide.”
But it would be even more effective to be able to take the advertiser to court and win a false advertising suit, said Franklin Zimring, director of the Earl Warren Legal Institute at the University of California at Berkeley.
But winning such a suit can be difficult. The U.S. Supreme Court ruled in 1992 that tobacco companies could be sued by smokers who developed health problems, but so far none of the more than 150 suits filed has been successful.
Some successful negligence suits against gun dealers have been brought, said Sanford Fox of the Boston College of Law, but they “did not result in the kind of damages that would put a manufacturer or seller out of business.”
“What would be most effective would be to have the federal government enforce its bookkeeping regulations for licensed gun shops,” Fox said. “That way we could be sure that the guns that got into their hands legally also got out of their hands legally.”
Zimring says he is most optimistic about the possibility that manufacturers and sellers could be successfully sued for negligence if they sold guns to someone who was not eligible to own a gun.
But the federal government has long been criticized for its failure to keep track of the gun industry. The U.S. Bureau of Alcohol, Tobacco and Firearms has 220 inspectors to keep track of 287,000 gunshops.
Even when ATF inspectors discover that gun sellers are not keeping accurate records of who buys their guns, little is done. In 1992, only 24 gun licenses were revoked while 35,562 new licenses were issued.
Others have suggested that guns could be declared inherently dangerous consumer products, making manufacturers liable for injuries, but Zimring called that “a back-door approach that wouldn’t be as effective as a direct, public health campaign.”
Without question, guns are the most visible target of those who are fighting the violence.
But running parallel to the gun control efforts are programs that try to teach children from violent homes and neighborhoods how to settle disputes peacefully.
In Chicago, for example, social workers at Spry Elementary School and Saucedo Scholastic Academy on the West Side are collaborating on a program developed by a Seattle non-profit group, Committee for Children, aimed at reducing aggressive behavior among students, said John Greven, a social worker at Spry.
The Spry-Saucedo program is being planned and will begin in January, Greven said. It will focus on developing empathy, impulse control and anger management in students.
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At the same time, Dr. Gary Strange, head of the emergency medicine department at the University of Illinois Hospitals, is starting programs in junior highs and high schools to convince children that violent deaths are preventable.
But Strange says that it “is not a short term goal and not an easy one. It may be five years, or the next generation, before we know if these programs work.”
Researchers are only beginning to develop violence reduction programs for children and adolescents. There is no evidence yet that any work.
Dr. Carl Bell, professor of psychiatry at the University of Illinois at Chicago, was appalled recently when several youngsters went home and bought guns after a 3-day seminar that he had led on violence reduction.
When he asked the boys why they bought the guns, Bell found that they all had seen someone shot years before. Three days of talking about violence stirred up so many unresolved feelings of helplessness that they felt compelled to buy firearms for protection.
“We really don’t know what works yet in violence-reduction strategies,” Bell said. “We’ve got different people all around the country trying things out. We’ve got to get those people into a room to start collaborating and developing state-of-the-art programs.”